关键词: 丙型肝炎, 肝硬化, 直接抗病毒药物

Abstract: Objective To investigate the current treatment situation and explore the impact factors for short-term prognosis after direct-acting antiviral (DAA) therapy in Chinese patients with hepatitis C virus (HCV)-related liver cirrhosis.Methods Patients with HCV-related liver cirrhosis who visited the clinical center from Jan 2015 to Nov 2019 at the Department of Infectious Diseases, Ruijin Hospital, Shanghai Jiaotong University were enrolled. Clinical characteristics and DAA treatment status were collected according to current international practice guidelines. Impact factors for treatment responses and short-term prognosis after treatment were analyzed in the followed-up populations. Results A total of 161 patients with HCV-related liver cirrhosis were included, among which 149 received DAA therapies, 122 compensated and 27 decompensated. Baseline charactersitics, including age, gender, HCV genotype and previous interferon (IFN) exposure history, were comparable between compensated and decompensated groups. Excellent treatment responses along with extremely low incidences of adverse events were achieved in both groups (both P<0.05). Rates of SVR12 and SVR24 were 99.17% vs. 96.25% (P=0.325) and 96.64% vs. 92.0% (P=0.614) in compensated and decompensated groups. Significant poorer prognosis was demonstrated in patients with decompensated cirrhosis when compared to compensated cirrhosis (50% vs. 13.75%,P=0.000). The area under the receiver operating characteristic curve revealed decompensated cirrhosis before the initiation of treatment to be the only predictive factor for short-term prognosis after DAA treatment (HR 6.765,95% Cl:2.866-15.969,P=0.000).Conclusion Decompensated cirrhosis before the initiation of treatment was an independent impact factor for short-term prognosis after DAA treatment in HCV-related cirrhotic patients.

Key words: Hepatitis C infection, Liver cirrhosis, Direct-acting antiviral agents